Development
organization Oxfam explains why the following conditions industrialized
countries and big drug companies seek to impose on the implementation
of Paragraph 6 of the Doha declaration on TRIPS and public health will
ill-serve the sick and poor the provision is supposed to benefit.

The
‘solution’ should only apply to AIDS, TB and malaria, and only to medicines.

Oxfam
objection: There is no rationale for restricting the scope to these diseases.
There are many other diseases that ravage developing countries, for which
the treatments are, or will be, patented and expensive. For example, Hepatitis
C, which can be fatal, affects 8-10 million people in Egypt alone. Drug-resistant
diseases are spreading fast, with enormous human cost: pneumonia kills
hundreds of thousands of children every year, while gonorrhoea causes
immense suffering for millions of women. Half the victims of the major
non-communicable diseases (cardiovascular diseases, cancer, diabetes,
chronic respiratory diseases and hereditary disorders) are now from the
developing world, often from poorer communities.

The
solution should cover not only medicines but also vaccines, diagnostic
kits and other health products, as these can be patented and expensive.

Beneficiary
countries should only be the 49 least-developed countries or the low-income
developing countries.

Oxfam
objection: This condition denies equal rights of access to generic medicines
for at least 72 developing countries that cannot, with the probable exception
of China, produce the generic versions of new drugs for themselves or
do so at a reasonable price. Tens of millions of needy people in countries
with limited public health budgets, such as Brazil, Peru, the Dominican
Republic, South Africa, Honduras and Namibia, would be excluded from benefit.

Developing
countries also argue that the mechanism should allow countries in a regional
trade agreement to import generics as a group, or that one of the members
should be able to supply the regional market with generics, which would
permit economies of scale. In addition, Oxfam supports their complementary
proposal that the North should help to improve capacity in their pharmaceutical
sectors by transferring knowhow and technologies, since a thriving local
industry is the best guarantee of improved access to medicines and overall
“health security.” In the longer term, prospects for such industries will
be greatly enhanced by much more substantial reform of the patent rules.

The
exporting-country government must issue a compulsory licence to permit
production and export of the generic version of the patented product,
on a case-by-case basis.

Oxfam
objection: It is totally unreasonable to expect the importing country
to depend on the political will of another government for access to affordable
medicines. Pakistan might need to commission a drug from a manufacturer
in India, which is one of the very few developing countries with a sophisticated
pharmaceutical industry. It should not have to depend on the Indian government’s
willingness to authorize such production. Moreover, the exporting country
would be vulnerable to external pressure not to give its consent. Having
to seek compulsory licences in both importing and exporting countries
also adds to the administrative burden.

Developing
countries must negotiate with the patent holder prior to using the mechanism,
can only resort to it if the price offer is unsatisfactory, and must formally
notify the WTO of their intention.

Oxfam
objection: These conditions are unfair because they go beyond existing
TRIPS obligations faced by a rich country if it decides to override a
patent; they are designed to slow down and complicate the whole process
for a developing country.

Only
developing countries should be able to produce for export under this mechanism.

Oxfam
objection: This condition sounds enlightened but is intended to reduce
the number of potential suppliers of generic medicines, to the advantage
of the big drug companies. Any country should be allowed to export under
the mechanism.

Developing
countries should undertake measures to prevent the flow of generic medicines
back to the markets where the drug is under patent.

Oxfam
objection: The main burden for this should rest with industrialized countries,
which already have the means for enforcement (e.g., the recent European
proposal to label reduced-price medicines destined for developing countries
in order to police illegal re-imports back to Europe). Any measures required
of developing countries should be proportionate to the problem and to
their capacity.

The
above is extracted from an Oxfam press release (14 November 2002). Oxfam
is a development, relief and campaigning organization dedicated to finding
lasting solutions to poverty and suffering around the world.